Etch–Bleach–Seal Technique in Managing Enamel Hypomineralization: A Case Report With Narrative Literature Review

Background: Molar incisor hypomineralization (MIH) opacities significantly affect pediatric patients' esthetics and psychosocial well-being. This case is unique as it demonstrates the clinical efficacy of a modified etch-bleach-seal protocol, utilizing a double application of sodium hypochlorite to address deep pigmentations where standard conservative approaches may be limited. Objective: This study is aimed at evaluating the clinical efficacy and existing literature supporting the etchâ€"bleachâ€"seal technique, a minimally invasive approach developed by Wright for managing enamel hypomineralizationâ€"related opacities. Case Description: A 10-year-old female presented with esthetic concerns regarding yellow-brown discoloration on her upper central incisors. After clinical and radiographic evaluations, a diagnosis of MIH was established. The patient was treated using the etch-bleach-seal technique, including phosphoric acid etching, sodium hypochlorite bleaching, and ICON resin sealing. Outcomes: Posttreatment, the patient showed significant improvement in enamel appearance. A follow-up session at 3 months led to further enhancement of esthetic results. Conclusion: The modified etch-bleach-seal protocol appears to be a promising conservative option for deep MIH opacities. However, as this represents a single clinical case, longitudinal studies are warranted to confirm its long-term durability and impact on enamel integrity.